The anatomic coracoclavicular ligament reconstruction: surgical technique and indications.

The anatomic coracoclavicular ligament reconstruction (ACCR) is a surgical procedure to address acriomioclavicular joint instability. The coracoclavicular ligaments are reconstructed using a semitendinosus allograft passed beneath the coracoid and through bone tunnels in the clavicle. The graft is secured with interference screw fixation, and the acromioclavicular joint is retained. Here we describe the authors' surgical technique, indications, and rehabilitation protocol. Also, a preliminary case series of seventeen patients is presented. Patients demonstrated significant improvement in pain levels and function. The mean ASES score increased from 52 preoperatively to 92. The Constant Murley rose from 66.6 to 94.7. There were three failures in this series, and two required revision surgery.

Anteromedialization of the tibial tubercle for patellofemoral arthritis in patients > 50 years.

This is a retrospective study of one surgeon's experience performing anteromedialization of the tibial tubercle for the treatment of isolated patellofemoral arthritis in active older patients. Patients were included if they were > 50 years at the time of the surgery and had a minimum follow-up of 2 years. Outerbridge classifications were documented by arthroscopy, and patellofemoral alignment was evaluated clinically and radiographically. Lysholm and Fern pain scores were obtained via mailed questionnaire or phone survey. A total of 22 anteromedialization procedures were performed on 17 patients who met the inclusion criteria; 82% of patients completed the followup survey. Mean age was 55 years. Mean follow-up was 77 months. Mean postoperative Lysholm score was 83. Based on Lysholm scores, there were 12 good to excellent, 6 fair, and 1 poor outcomes. Anteromedialization of the tibial tubercle is a definitive treatment option for isolated patellofemoral arthritis in active older patients.